2024 WELLCARE MASTERY TEST ACTUAL EXAM 130 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE

2024 WELLCARE MASTERY TEST ACTUAL EXAM 130 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE The Mastery Exam will lock for a period of 48 hours after each failed attempt. -ANSWER- False Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-month grace period) will be terminated. - ANSWER- True True - ANSWER- True Which of the following is not an example of Protected Health Information (PHI)? -ANSWER- Library card Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. - ANSWER- True Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a Wellcare quality driver? - ANSWER- c. Member Payments Communication of PHI can be: (Select all that apply.) - ANSWER- a. Written b. Electronic c. Verbal A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: - ANSWER- a. Appeal An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. - ANSWER- True An LEP is assessed by CMS when a member goes ______ days or longer without creditable prescription drug coverage after they become Medicare-eligible. - ANSWER-63 Days Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. - ANSWER- True Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. - ANSWER- False When completing an enrollment, be sure to use the correct enrollment application for the desired plan year. - ANSWER- True When completing an application, you should ensure that you enter the provider ID of a specialist and not a primary care provider (PCP). Question 17Select one:True - ANSWER- False Once the enrollment is completed, you can save a copy of the application for your reference. - ANSWER- False Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. - ANSWER- True Wellcare expanded our county footprint in _____ states for 2024. - ANSWER- Five All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies. - ANSWER- True For Prescription Drug Plan (PDP) Medication Home Delivery, the ____ plan will continue to offer a discount (2.5 x 30-day preferred retail copay) for Tier 2, 3, and 6 prescriptions. - ANSWER- Value Plus Which LIS category is assigned to members whose costs are fully subsidized and who receive the most assistance? - ANSWER- Three Which is the Prescription Drug Plan (PDP) Preferred Mail Order network for 2024? -ANSWER- a. Express Scripts Pharmacy Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM, OH, OK, TX, and WI. - ANSWER- True Members who have LIS and enroll in other plans will have a premium to pay regardless of the level of LIS the member is granted. - ANSWER- True The _________ plan is expected to have one of the lowest premiums in the country! -ANSWER- c. Value Script All Prescription Drug Plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through Express Scripts Pharmacy (Mail Order). - ANSWER- True The Prescription Drug Plan (PDP) network is expected to include over ____ total pharmacies. - ANSWER- Sixty Thousand Which Prescription Drug Plan (PDP) product features no deductible on any tier? -ANSWER- Value Plus Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from the beneficiary. - ANSWER- 1 Which elements are available as part of Wellcare's Sales Support model? - ANSWERAll of these Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums - ANSWER- False Prior to completing the enrollment form, broker/agents should always confirm the beneficiary's primary care provider (PCP) and/or specialists - ANSWER- True At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85% or higher to successfully complete this course - ANSWER- True Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a - ANSWER- Complaint Tracking Module (CTM) Grievance Secret Shop Finding A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. - ANSWER- False Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (formaland informal). - ANSWER- False Marketing benefits in a service area where those benefits are not available is prohibited and considered misleading unless that is unavoidable because of local/regional or media use. - ANSWER- True CustomPoint sales material order dates will be posted on W - ANSWERFalse The online Centene Workbench self-service portal enables you to - ANSWER- All of these The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one MA plan provider. The disclaimer must be: - ANSWER- Included in any marketing materials, including print materials and television advertisements developed, used, or distributed by the TPMO. Verbally conveyed within the first minute of a sales call. Prominently displayed on TPMO websites (regardless of content). Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication (regardless of content). Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench. - ANSWER- All of these Which of the following is not an example of Protected Health Information (PHI)? -ANSWER- Library Card When a paper SOA form is used, it must be completed __________ hosting the sales presentation. - ANSWER- 48 Hours prior to Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. - ANSWER- True When explaining the provider network for D-SNPs and C-SNPs: - ANSWER- Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk members. If a member is not connected to a primary care provider (PCP), we should always encourage and assist with connecting them with an in-network doctor If a requested effective date is available for the special election period b eing selected, ensure you are requesting a date within the correct time frame for the member based on their eligibility date or change date needed. - ANSWER- True Wellcare's _____ plan is designed for Low-Income Subsidy members. - ANSWERClassic Which LIS category is assigned to members whose costs are fully subsidized and who receive the most assistance? - ANSWER- Three The _________ plan is expected to have one of the lowest premiums in the country! -ANSWER- Value Script The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery chains in 2024. - ANSWER- True Wellcare continues to expand its reach by offering more products in